Trans inequalities in English perinatal care

About a month ago I participated in the TPATH conference. This groundbreaking online event centred trans healthcare practice, research, and activism by and for trans people.

I was very impressed with the measures taken by TPATH organisers to ensure the conference was accessible to as many people as possible from around the world. They organised live translation to and from English, French, and Spanish, provided live captioning, encouraged presenters to speak slowly and clearly to enable lipreading, and ensured that generous scholarships were available for those who would not otherwise afford to attend. Most of the event was recorded, and videos are gradually being uploaded to the TPATH Youtube channel.

At the conference I joined Tash Oakes-Monger from NHS England to present initial findings from the ITEMS project (Improving Trans Experiences of Maternity Services). The ITEMS team, led by Michael Petch from the LGBT Foundation, ran a survey in early 2021 to explore the experiences of trans people (including non-binary people) who give birth in England. I supported the design and dissemination of the survey through my former role with the Trans Learning Partnership.

Bar chart indicating that increasing numbers of trans and non-binary people are giving birth in England every year.
Bar chart indicating growth in number of trans people giving birth in England each year.


There is some really exciting information emerging from the ITEMS data. For example, it appears that more trans people are giving birth than ever before (see above). However, it was also apparent that trans people face substantial inequalities.

Many of the questions in the ITEMS survey used comparable wording to the CQC Maternity Survey – from this we can see that trans people appear more likely to have negative experiences in NHS maternity services than cis women across the board. Even more disturbing is that 30% of trans respondents gave birth without the support of an NHS or private midwife (rising to 46% among trans people of colour). This indicates a lack of trust in midwifery services among prospective trans birth parents, with potentially lethal consequences for both parent and baby.

To learn more, you can watch our presentation on the TPATH Youtube channel.

A formal report of ITEMS findings should be published in the coming months.

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